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Efficacy and complications of neurosurgical treatment of acromegaly

The aim of the study was to evaluate the frequency of occurrence of pituitary failure following neurosurgery and the efficacy of transsphenoidal tumour resection in acromegalic patients. We retrospectively evaluated 85 patients (60 female and 25 male), of mean age 43.9 ± 13.2 years, treated by trans...

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Autores principales: Krzentowska-Korek, Anna, Gołkowski, Filip, Bałdys-Waligórska, Agata, Hubalewska-Dydejczyk, Alicja
Formato: Texto
Lenguaje:English
Publicado: Springer US 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094540/
https://www.ncbi.nlm.nih.gov/pubmed/21107739
http://dx.doi.org/10.1007/s11102-010-0273-0
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author Krzentowska-Korek, Anna
Gołkowski, Filip
Bałdys-Waligórska, Agata
Hubalewska-Dydejczyk, Alicja
author_facet Krzentowska-Korek, Anna
Gołkowski, Filip
Bałdys-Waligórska, Agata
Hubalewska-Dydejczyk, Alicja
author_sort Krzentowska-Korek, Anna
collection PubMed
description The aim of the study was to evaluate the frequency of occurrence of pituitary failure following neurosurgery and the efficacy of transsphenoidal tumour resection in acromegalic patients. We retrospectively evaluated 85 patients (60 female and 25 male), of mean age 43.9 ± 13.2 years, treated by transsphenoidal neurosurgery. Macroadenoma and microadenoma of pituitary were found in 66 (77.6%) and 19 (22.4%) of these patients, respectively. Criteria of cure following neurosurgery were: basal GH < 2.5 μg/l, GH at 120 min in OGTT < 1.0 μg/l and serum concentration of IGF-1 within normal ranges for age and sex. After surgery 32 patients (37.6%) were cured and 53 patients (62.4%) required somatostatin analogue treatment. In patients cured by surgery, lower levels of basal GH (P < 0.05), IGF-1 (P < 0.001), GH at 120 min in OGTT and smaller size of pituitary tumour (P < 0.05) were found at diagnosis, as compared to patients in whom surgery was unsuccessful. Significant correlation between basal serum level of GH at diagnosis and size of pituitary tumour was found (P < 0.001). Invasive tumours were found in 45 of 53 (84.9%) patients not cured and in only 8 of 32 (25.0%) patients cured (P < 0.001). Impaired function of pituitary anterior lobe after surgery was observed in 30% and 4% of patients with macro- and microadenoma, respectively (P < 0.05). The efficacy of neurosurgery is affected by concentration of basal serum GH and IGF-1, GH at 120 min in OGTT, tumour size and invasiveness. Hypopituitarism after surgery is more frequent in patients with macroadenoma. Pituitary insufficiency, as a consequence of surgery, was found in 21% of patients with normal pituitary function prior to operation.
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spelling pubmed-30945402011-07-07 Efficacy and complications of neurosurgical treatment of acromegaly Krzentowska-Korek, Anna Gołkowski, Filip Bałdys-Waligórska, Agata Hubalewska-Dydejczyk, Alicja Pituitary Article The aim of the study was to evaluate the frequency of occurrence of pituitary failure following neurosurgery and the efficacy of transsphenoidal tumour resection in acromegalic patients. We retrospectively evaluated 85 patients (60 female and 25 male), of mean age 43.9 ± 13.2 years, treated by transsphenoidal neurosurgery. Macroadenoma and microadenoma of pituitary were found in 66 (77.6%) and 19 (22.4%) of these patients, respectively. Criteria of cure following neurosurgery were: basal GH < 2.5 μg/l, GH at 120 min in OGTT < 1.0 μg/l and serum concentration of IGF-1 within normal ranges for age and sex. After surgery 32 patients (37.6%) were cured and 53 patients (62.4%) required somatostatin analogue treatment. In patients cured by surgery, lower levels of basal GH (P < 0.05), IGF-1 (P < 0.001), GH at 120 min in OGTT and smaller size of pituitary tumour (P < 0.05) were found at diagnosis, as compared to patients in whom surgery was unsuccessful. Significant correlation between basal serum level of GH at diagnosis and size of pituitary tumour was found (P < 0.001). Invasive tumours were found in 45 of 53 (84.9%) patients not cured and in only 8 of 32 (25.0%) patients cured (P < 0.001). Impaired function of pituitary anterior lobe after surgery was observed in 30% and 4% of patients with macro- and microadenoma, respectively (P < 0.05). The efficacy of neurosurgery is affected by concentration of basal serum GH and IGF-1, GH at 120 min in OGTT, tumour size and invasiveness. Hypopituitarism after surgery is more frequent in patients with macroadenoma. Pituitary insufficiency, as a consequence of surgery, was found in 21% of patients with normal pituitary function prior to operation. Springer US 2010-11-25 2011 /pmc/articles/PMC3094540/ /pubmed/21107739 http://dx.doi.org/10.1007/s11102-010-0273-0 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Krzentowska-Korek, Anna
Gołkowski, Filip
Bałdys-Waligórska, Agata
Hubalewska-Dydejczyk, Alicja
Efficacy and complications of neurosurgical treatment of acromegaly
title Efficacy and complications of neurosurgical treatment of acromegaly
title_full Efficacy and complications of neurosurgical treatment of acromegaly
title_fullStr Efficacy and complications of neurosurgical treatment of acromegaly
title_full_unstemmed Efficacy and complications of neurosurgical treatment of acromegaly
title_short Efficacy and complications of neurosurgical treatment of acromegaly
title_sort efficacy and complications of neurosurgical treatment of acromegaly
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094540/
https://www.ncbi.nlm.nih.gov/pubmed/21107739
http://dx.doi.org/10.1007/s11102-010-0273-0
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